1. Foot, Ankle, & Lower Leg Anatomical Structures

2. Bones 28 bones in the foot Toes = phalanges (14 bones) Sesamoids Metatarsals (5 bones) Cuboid, Navicular, Cuneiforms (3) Talus, Calcaneus

3. Bones Talus Calcaneus Cuboid Cuneiform Intermediate Cuneiform Lateral Cuneiform Medial NavicularNavicular Metatarsals ProximalPhalanges Middle Phalanges Distal Phalanges Sesamoid Joints Distal Inter – Phalangeal Joint Proximal Inter- Phalangeal Joint Metatarso- Phalangeal Joint

5. Dot labeling DP MP PP Mt MC IC LC Cu Nav Tal Cal MM LM

6. Medial Side Metatarsals –1 st -4 th : Top of the foot from the MP joint (last “knuckle”) until you feel the next “bump” Distal Phalanges – tips of your toes Proximal Phalanges – the start of your toes

7. Medial Navicular -Navicular - the prominent structure on the medial side of the foot. Cuneiform Medial: Between the proximal end of the 1st metatarsal and the navicular tuberosity Medial Malleolus Bone sticking out on the inside

8. Anterior Proximal Phalanges – the start of your toes Middle Phalanges – middle part of your toes Distal Phalanges – tips of your toes Metatarsals 1st-4th : Top of the foot from the MP joint (last “knuckle”) until you feel the next “bump”

9. Cuneiform Intermediate and Lateral – after the “bump” (the proximal end of the metatarsals) of the 2nd and 3rd toes, you will be on the Intermediate (2nd met) and Lateral (3rd met) Cuneiforms

10. Lateral 5 th Metatarsal: lateral side of the foot, the proximal end is the most prominent point on the lateral side. Cuboid: Palpate the styloid process of the 5th metatarsal, then move promixmally and note a groove

11. Lateral Malleolus - Bone sticking out on the lateral side Talus - The divot anterior and inferior to lateral malleolus Calcaneus - Your heel Peroneal Tubercle: This tubercle is the most prominent landmark on the calcaneous located inferior and anterior to the lateral malleolus

13. Bones of Lower Leg

14. Arches of the Foot Longitudinal Arch –Runs from Calcaneus to the Metatarsal Heads –Acts as a shock absorber –Proximal end of the Feet are very important! Transverse Arch –Across the metatarsal heads

15. Longitudinal Arch

16. Ligaments What does a ligament do? What is the name for the injury to a ligament?

17. Lateral Ligaments Anterior Talo-fibular Ligament (ATF) Calcaneofibular Ligament (CF) Posterior Talo-fibular Ligament (PTF)

18. -Anterior Tibio-Fibular Ligament (Anterior Tib-Fib) -Posterior Tibio-Fibular Ligament (Posterior Tib-Fib)

19. Deltoid Ligament - Made up of 4 ligaments in one!

20. Muscles of lower leg, ankle, & foot Gastrocnemius –O: Medial and Lateral Condyle of the Femur –I: Calcaneus –A: Flex knee, pf ankle Soleus (Achilles Tendon) –O: Proximal fibula, middle tibia –I: Calcaneus –A: pf ankle

21.  Gastrocnemius Soleus

22. Muscles of Lower Leg Flexor Hallucis Longus –O: Middle posterior fibula –I: Distal Phalenx of great toe –A: Pf and inv of ankle, flex great toe

23. Muscles of Lower Leg Flexor Digitorum Longus –O:Posterior Tibia –I: Distal phalanges of toes 2-5 –A: pf and inverson of ankle, flex toes 2-5

24. Muscles of Lower Leg Tibialis Posterior –O: Middle posterior tibia and fibula –I: Navicular, medial cuneiform, and metatarsals 2-5 –A: pf and inversion of ankle

25. Muscles of Lower Leg Peroneus Longus –O: lateral tibia and proximal fibula –I: Proximal end of 1 st metatarsal (plantar side) –A: Eversion/ PF Peroneus Brevis –O: middle fibula –I: 5 th metatarsal –A: Eversion/ PF

26. Muscles of Lower Leg Tibialis Anterior –O: lateral proximal tibia –I: medial cuneiform and Proximal end of 1 st metatarsal –A: Dorsiflexion/ inversion

27. Muscles of Lower Leg Extensor Digitorum Longus –O: Lateral tibia/ proximal fibula –I: phalanges of 2-5 –A: DF, Eversion, Extension 2-5 Extensor Hallucis Longus –O: Middle fibula –I: distal phalanx great toe –A: DF, Inversion, Extension great toe

28. Muscles of Lower Leg Structures

29. Muscles of Lower Leg

32. What muscles Invert the foot Evert the foot Plantarflex Dorsiflex